Inequalities in Self-reported Oral Health of U.S. Adults 1999-2014

Abstract

Objectives: To describe absolute and relative sociodemographic inequality (AI and RI) trends in self-reported oral health (SROH) of U.S. adults. Methods: SROH data from the National Health and Nutrition Examination Survey from 1999 to 2014 were analyzed. Survey weighted multivariable logistic regression on SROH considering survey period, five categorical sociodemographic factors: age, gender, race/ ethnicity, education level and Family Poverty Income Ratio (PIR) and their possible interactions was conducted. AI and RI in SROH were measured by the rate difference and rate ratio of the predicted probabilities of “excellent or very good”. Results: Survey-weighted proportions of “excellent and very good” rating for SROH increased from 27% to 38% in 1999-2014 (n=46,621 adults aged 20+ years). AI and RI in SROH between gender remained stable over time (AI: 6.0%-6.5%; RI: 11.18-11.15). Race/ethnicity and family PIR had similar trend patterns; AI slightly increased from 13.7% and 14.5% in 1999-2000 to 16.1% and 17.2% in 2013-2014 while RI slightly decreased from 1.69 and 1.77 in 1999-2000 to 1.59 and 1.65 in 2013-2014 respectively. Both AI and RI in SROH showed larger fluctuations over time among age and education groups. AI slightly increased from 12.4% to 13.5% and RI slightly reduced from 1.42 to 1.33 among age groups. Both AI and RI in SROH among education groups increased from 13.1% and 1.48 in 1999-2000 to 23.0% and 1.71 in 2013-2014 respectively. Conclusions: Absolute sociodemographic inequalities in SROH slightly increased and the relative inequalities slightly decreased from 1999 to 2004 except for education. Both inequalities increased in U. S. adults. This demonstrates that sociodemographic inequalities are prevalent among U.S adult.